Abstract Assessing the Accuracy of Self-Report of HIV Testing Behavior Funding Opportunity Announcement RFA-PS-09-002 HIV/AIDS Surveillance Program Houston Department of Health and Human Services Houston, Texas The Houston Department of Health and Human Services (HDHHS) is applying for funding under FOA PS-09-002 to conduct the proposed study to assess and validate the accuracy of self- reported HIV testing behavior. The city of Houston is the fourth largest city in the nation and has the eighth largest number of AIDS cases reported by city. The first documented case of AIDS in Houston was reported in 1981 and AIDS has been a reportable disease in Texas since 1983. In January 1999, name-based HIV reporting in Texas became mandatory for all persons who have a confirmed diagnostic test performed after 1998 and on January 1, 2000, a detectable viral load was added to the reportable diagnostic tests. Approximately 900 AIDS cases and 1,200 HIV cases have been diagnosed each of the past five years. Through 2007, 75% of Houston's reported HIV cases were among minorities. HDHHS reports HIV and AIDS for the city of Houston and Harris County, Texas. Since 1989, HDHHS has been directly funded by the Centers for Disease Control and Prevention (CDC) to conduct HIV/AIDS surveillance activities. Houston's HIV/AIDS Surveillance Program has received additional funding for HIV-related projects at numerous times in its twenty year history. HDHHS has been funded for incidence surveillance since 2002 and the program was fully implemented and integrated with core surveillance in June 2005. Through the proposed project, HDHHS will determine the validity of self-reported HIV testing history information and identify systematic recall bias, if any, overall or by sub-population. The HDHHS project team will collaborate with the CDC to 1) partner with at least one medical clinic and at least one publicly funded confidential counseling, testing, and referral facility to recruit participants for the study, 2) develop interview questions related to previous HIV testing, results, and dates, 3) conduct medical record abstraction to determine whether participants have had an HIV test, the participants'HIV status, and the date and location of the most recent negative HIV test for individuals who have had at least one HIV test, and the date and location of the first positive test for individuals who are HIV positive, 4) conduct interviews with participants to ascertain self-report of whether the participants have had a HIV test, their HIV status, the date and location of the most recent negative HIV test for those who have had at least one HIV test, and the date and location of the first positive HIV test for individuals who are HIV positive, 5) assess the sensitivity, specificity, kappa statistic, and accuracy of recall of test date for self- reported testing history information, and 6) determine if differences exist in sensitivity, specificity, and accuracy by race, sex, age, or transmission category. The HDHHS HIV Surveillance Program is housed in the Bureau of Epidemiology, Office of Surveillance and Public Health Preparedness. HIV surveillance staff are trained in surveillance procedures and protocols developed following CDC guidelines with special consideration to confidentiality and security. PUBLIC HEALTH RELEVANCE: Statement of Public Health Relevance Assessing the Accuracy of Self-Report of HIV Testing Behavior Funding Opportunity Announcement RFA-PS-09-002 HIV/AIDS Surveillance Program Houston Department of Health and Human Services Houston, Texas Through the proposed project, "Assessing the Accuracy of Self-Report of HIV Testing Behavior" (FOA PS-09-002), the Houston Department of Health and Human Services (HDHHS) will determine the validity of self-reported HIV testing history information and identify systematic recall bias, if any, overall or by sub-population. Testing and treatment history information from HIV positive individuals is used in conjunction with results from the serologic testing algorithm for recent HIV seroconversion (STARHS) to provide a direct population-based estimate of HIV incidence. If the self-reported testing history data is biased, the incidence of HIV infection will be inaccurate. Therefore, it is imperative that the accuracy of self-reported HIV testing behavior be assessed and validated to determine the potential effect on the HIV incidence estimate.